The information I use in this blog has been inspired by the work of Martha Kauppi, Marty Klein, Emily Nagoski and Barry McCarthy.

There comes a point in the treatment with a couple, when we have to start talking about sex. Talking about sexual issues is not the easiest for couples to do, but let’s face it: for most of us, it’s not easy either.

Getting more comfortable talking with our clients about sex will help the couple become more comfortable. At a minimum, we need to be able to discuss pleasure, desire, and arousal.

We don’t need to be certified sex therapists in order to help our couples navigate these conversations.  I prefer doing the sexual clinical work myself because I am good at assessing -and describing for the couple- the reciprocal nature of their interactions around sexual issues.

When we talk about sex with our clients:

1. We help them become comfortable with the language of sexual pleasure
2. We can educate them so they become more sexually intelligent
3. We can push them forward toward becoming more sexually differentiated
4. We help to create shifts in their perspective which may lead to the end of blame, a necessary precursor of sexual activity.

What is sexual desire discrepancy?

Sex is the adult version of childhood play. Couples are often able to play well when they first meet, but, sometimes, something happens in the second stage of the relationship and they stop playing.

Sexual desire discrepancy is one of the most common presenting issues in couples therapy, whether the clients present it as such or not. Discrepancy is actually not a problem per se. It only becomes a problem because of the meaning that couples attribute to the difference and because of the way they manage that difference.

After the romantic period is over, desire discrepancy is normal. No relationship survives over decades without the partners discovering some significant differences between them. In this case, the difference they experience happens to be about sex, but it’s still just a difference of preferences between two people. 

Sexual desire discrepancy is no different than any other difference in couples, but it is made more fraught because it triggers sensitive feelings in each member of the couple. It can create a toxic relationship dynamic of mutual blame, leading to an interactional

pattern that is difficult to break. The higher desire person feels rejected and blames the lower desire partner. In some cases, the higher desire person exerts pressure and in extreme cases, coercion. And the lower desire person blames the higher desire partner for their external pressure, and may feel some internal pressure of their own.

The higher desire person often feels like they are “owed sex” and the lower desire partner may feel that they “owe sex” or “don’t owe sex” to their partner.

Alternatively, the lower desire person may denigrate the wishes of the higher desire partner for wanting more sex than they do.

Many partners experience shame from having high desire, or low desire, or no desire. Or they blame their partners because they think their partners are not normal for having a higher desire or a lower desire. Shame and blame are not conducive to pleasure, play or fun which are the basic elements of an intimate encounter.

The more they blame each other, the fewer sexual encounters they have and the less they touch each other. At its best, couples come in early enough when the damage is minor. At its worst, couples come in for treatment after years of this dynamic marred in resentment and blame. The damage can be severe. The longer this has been going on for, the harder it is to change.

Sexuality 101 as it pertains to sexual desire discrepancy

Most of us didn’t learn about sexuality in an informative, straightforward way. Much of what is circulating in our culture about sex, intimacy and sexuality is based on myths, misinformation, porn use, or bad school sex education. Most school-based sex education, for example, doesn’t even mention the word pleasure, or clitoris or masturbation.

Moreover, many people think they ought to know sexual issues even though they didn’t get the education. They also assume other people know. Neither feel comfortable talking about sex.

Here are some of the issues I discuss with the couples I work with who present with sexual desire discrepancy.

1. There is no such thing as an “abnormal” level of desire. There is so much variability between human beings, and such infinite diversity in the world, that I think we are all normal.
2. Couples are unlikely to feel amorous at the same time. The expectation that desire and arousal should be felt by both partners in the same way and at the same time is often how desire discrepancy first manifests in a couple.
3. “Sex has to be hot, spontaneous, luxurious, and last a lifetime”. If this is how some partners think about sex, I tell them that “This is a young adult vision of how sex occurs”. This is a second way that desire discrepancy manifests itself. The belief that sex has to be spontaneous and luxurious and last a lifetime goes against the reality that sex evolves, and becomes less frequent over time. The trouble often begins when couples continue to use their young adult vision of sexual intimacy as the blueprint of what needs to happen in their relationship. A young adult vision of sex includes several ideas: Instant wetness, rock hard erections, pounding intercourse and simultaneous orgasms, among others.
4. Some partners believe that kissing or other touching activity has to automatically lead to sex. When that doesn’t happen, some people feel disappointment. The disappointment of one member may lead the other partner to avoidance behaviors. They start to avoid kissing, hugging, and snuggling. Believing that once a sexual interaction starts, it cannot be stopped makes some partners to back away from kissing or snuggling because of a fear that it will “send the wrong message and mislead their partner”.
5. Expecting that all their sexual pleasure should come from couple interactions, as opposed to self-pleasure leads to pressure. Pressure is not conducive to play.
6. Events and feelings are difficult to control or change, but what we can control are the narratives, the stories we tell ourselves about the events and the feelings. It’s hard to recover from the negative downward spiral when people make negative interpretations about themselves or their partners. “He doesn’t like the way I look”, “she is not interested in me”, “if he loved me, he would know what I like without me having to spell it out” are some of the negative narratives people tell about each other regarding sexual behaviors.
7. Most people say that what they want is to feel pleasure, and physical and emotional closeness and intimacy. However, this is not what most people focus on before or during sex. Rather, they may focus on how they look, how they smell, how they sound. Or they focus on preventing pregnancy, or unwanted activities. Or they focus on hurrying an orgasm, or maintaining an erection or enough lubrication, suppressing emotions such as being worried of not doing the “right things”, or suppressing wishes. No wonder things don’t work out when it comes to sexual desire discrepancy. Shame, anxiety and fear do not align with pleasure, desire and arousal.

Interventions that can be helpful with sexual desire discrepancy

In general, to deal effectively with sexual desire discrepancy issues, the couple is going to need to become better at sexual differentiation and they will need to develop sexual intelligence.

By sexual differentiation I mean each individual in the couple needs to learn to look inward and figure out what they think, feel and want and communicate that to their partner and they need to be able to manage the disappointment of not getting what they want. It also means that they can separate giving pleasure from receiving pleasure and become comfortable with both behaviors.

Becoming sexually intelligent means among other things, that we have the right information, the emotional skills to deal with the insecurities and an increased awareness of how our bodies respond.  For example, if one partner is anxious, it’s very hard to access relaxation; if another partner is resentful, it’s difficult to get aroused. Anxiety and arousal don’t go together. Resentment and arousal don’t go together either.

Sexual intelligence also means that we need to figure how to change our perspective and it teaches us to become more authentic and more open.

More specifically, here are some questions that I use to guide the therapeutic conversation in couples that present with sexual desire discrepancy. I talk to each of them separately, usually in joint sessions.

1. Are they talking about sex?

Find out if they are talking about sex. If they are not talking about sex, help them by talking about sex in therapy. Many couples therapists avoid talking about sex in therapy.

2. What do they think is normal?

I guide my clients in discussing their situation in terms of satisfaction, dreams, and desires, but I explain that the words “normal” or “abnormal” aren’t likely to be helpful to the discussion. Almost everyone is worried that something about their sexuality makes them deviant, disgusting, or broken. Partners of all genders are likely to feel shame about not measuring up to societal expectations or to what they themselves think is “normal” regarding arousal, desire, femininity or masculinity.

3. What are their initiation beliefs and routines?

Find out about their initiation routines and the beliefs about initiation: who, how, when do they initiate? How do partners respond to the initiation or another partner? What do they like or dislike about their partner initiation or lack of initiation? Are there gendered beliefs about initiation?

4. What are their beliefs about arousal?

Find out about how they turn themselves on by asking: What do you tell yourself to turn yourself on?

The lower desire person often says: I have no idea, and the higher desire person often says: She’s hot or he’s hot. Both of those answers operate under the believe that desire and arousal are external to the individual, which is not entirely true.

5. Can they think of sexual activity as having a menu of options?

Does each member of the couple have a belief that they have a menu of options to choose from? That not all touch leads to sex, that not all sex leads to orgasm?  

Find out if the lower desire person is able to say: Yes, no, maybe, not now, or only in this way. For example, the lower desire person can say: “I am ok with only a quickie”, or they could say “I can do it, provided that the dishes and the kid lunches for tomorrow are done”.

This is difficult for some low desire people, even though they can use a menu of options when it comes to other issues. “I can stay at the party is we take an Uber home”. “I can do this or that if we get something to eat first”. Why would it be any different when it comes to sex? Can the higher desire person be more clear about what they are in the mood for? Do they want naked touch, do they want help in having an orgasm? Do they want to be watched while they masturbate? Do they have in mind a long, elaborate production or could they be satisfied with a quick sexual encounter? Help them separate sex from performance and orgasm.

Help the couple separate touch from sex. Just because they are not having sex, doesn’t mean they can’t touch. You can discuss expectations, pressures, what they are each willing and able to do and their different love languages.

6. What are their beliefs about desire?

Desire is an inside job, assert many sex therapists. It is a good idea to help each partner create desire within themselves, particularly if they have a tendency to tell themselves that it is their partner’s job to do the initiating.

If a partner has to come up with all the desire, and all the self-activation toward putting desire into action comes from only one person, this may lead to problems.

Provide information about the difference between spontaneous desire versus responsive desire. Spontaneous desire refers to sexual desire that appears seemingly out of the blue, whereas responsive desire refers to sexual desire that is prompted by signs of sexual interest: touch, flirtation, or actually starting to have sex. Spontaneous desire is more commonly experienced in the romantic stage of the relationship. Both men and women can experience either one. Responsive desire is akin to not feeling like going to the gym, but once you started, you get into it, and when you are done, you’re glad you went. Spontaneous desire is the one that most people think when they think about desire: automatic, seemingly without internal input. It’s important to explain the difference.

When couples can begin to talk about their differences and their wishes without blame and without denigrating the wishes of their partner, they can find collaborative solutions.

When you think of sex as the adult playground, you can help the couple reignite their sexual life, like they did in the beginning. You can help them recreate not how hot it was, but the fact that they created the space and the time for it. Of course, you can only do this work with a couple who is aligned with the goal of increasing or restoring their sexual life by managing their differences better and without blame. If partners are not aligned with that goal, the interventions would be different.

If you find these suggestions helpful, drop me a note in the comments section. Join the free Facebook group "The Confident Couples Therapy" for more resources to help you sharpen your skills for doing couples therapy.